Gastrointestinal tube with inflatable bolus

Abstract

An intestinal catheter is inserted into the gastrointestinal tract by use of an endoscope or a guidewire in combination with an inflatable bolus and performs the functions of aspirating the stomach and feeding the small intestine. The inflatable bolus may be filled with a heavy liquid such as water so that the downstream end of the catheter is moved through the gastrointestinal tract by peristalsis.

I claim: 
     
       1. A catheter for insertion into the small intestine of a patient, said catheter comprising: a flexible tub having upstream and downstream ends;   a whisker at the downstream end of the tube, said whisker comprising means capable of being grasped by forceps that are attached to an endoscope;   an inflatable bolus near said downstream end and having an interior;   a bolus lumen in said tube;   a bolus opening communicating said bolus lumen with said interior of said bolus;   means, at said upstream end of the tube for connecting said bolus lumen with a source of fluid;   said bolus lumen, said bolus opening and said means for connecting with a source of fluid comprising means for inflating said bolus;   an opening near the downstream end of the tube;   a feeding lumen in said tube, communicating with said opening near the downstream end of the tube, and terminating at the upstream end of the tube;   means, at said upstream end of said feeding lumen, for connecting said feeding lumen to a source of nutritive or medicinal material;   gastric openings, in said flexible tube, between the upstream and downstream ends thereof, for aspirating the stomach;   a suction lumen in said tube, communicating with each gastric opening, and terminating at an upstream end adjacent the upstream end of the tube;   means at said upstream end of said suction lumen for connecting said lumen to suction;   a vent lumen in said tube and terminating at the upstream end of the tube;   a channel connecting said suction lumen to said vent lumen at a location no further upstream than the furthest downstream gastric opening; and   vent means at said upstream end of said vent lumen for communicating said vent lumen to the atmosphere;   said tube having a length such that, when its downstream end is in the small intestine, at least some of said gastric openings are in the stomach, and said channel, said vent lumen and said vent means comprise means for preventing said gastric opening from becoming plugged when aspirating the stomach.   
     
     
       2. The catheter of claim 1 wherein: said bolus has a center; and   said center is between 1 inch (2.54 cm) and 2 inches (5.08 cm) from said downstream end.   
     
     
       3. The catheter of claim 1 wherein: said bolus has a length of about 1 inch (2.54 cm).   
     
     
       4. The catheter of claim 1 wherein: said bolus has a volume such that when the bolus is inflated with water, it has a weight sufficient to enable peristalsis to carry the bolus further into the gastrointestinal tract.   
     
     
       5. The catheter of claim 1 wherein: said bolus has an inflated diameter which enables the bolus to engage the intestinal wall to assist in the prevention of withdrawal of the tube when an endoscope, which has been inserted in the gastrointestinal tract, is removed therefrom.   
     
     
       6. The catheter of claim 1 wherein: said tube has a length such that, when the downstream end of the tube is in the small intestine, the upstream end of the tube extends outwardly through the patient's nose.   
     
     
       7. The catheter of claim 1 wherein: said tube has a length such that when the downstream end of the tube is in the small intestine, the upstream end of the tube extends outwardly through the patient's skin adjacent the stomach.   
     
     
       8. A catheter for insertion into the small intestine of a patient, said catheter comprising: a flexible tube having upstream and downstream ends;   said tube having an opening in the tip of the downstream end;   a feeding lumen in said tube, communicating with said tip opening near the downstream end of the tube, and terminating at an upstream end adjacent the upstream end of the tube;   means, at said upstream end of said feeding lumen, for connecting said feeding lumen to a source of nutritive or medicinal material;   said feeding lumen comprising means for receiving a guidewire inserted through the feeding lumen's upstream end or through said tip opening in the downstream end of the tube;   a bolus near said downstream end of the tube, said bolus being inflatable and having an interior;   a bolus lumen in said tube;   a bolus opening communicating said bolus lumen with said interior of said bolus;   means, at said upstream end of the tube, for connecting said bolus lumen with a source of fluid;   said bolus lumen, said bolus opening and said means for connecting with a source of fluid comprising means for inflating said bolus;   gastric openings in said tube, between said upstream end and said bolus, for aspirating the stomach;   a suction lumen in said tube, communicating with each gastric opening, and terminating at an upstream end adjacent the upstream end of the tube;   means at said upstream end of said suction lumen for connecting said lumen to suction;   a vent lumen terminating at an upstream end adjacent the upstream end of the tube;   a channel connecting said suction lumen to said vent lumen at a location no further upstream than the furthest downstream gastric opening; and   vent means, at said upstream end of said vent lumen, for communicating said vent lumen to the atmosphere;   said tube having a length such that when its downstream end is in the small intestine, at least some of said gastric openings are in the stomach;   said channel, said vent lumen and said vent means comprising means for preventing said gastric openings from becoming clogged when aspirating the stomach.   
     
     
       9. The catheter of claim 8 wherein: said bolus has a center; and   said center is between 1 inch (2.54 cm) and 2 inches (5.08 cm) from said downstream end.   
     
     
       10. The catheter of claim 8 wherein: said bolus has a length of about 1 inch (2.54 cm).   
     
     
       11. The catheter of claim 8 wherein: said bolus has a volume such that when the bolus is inflated with water, it has a weight sufficient to enable peristalsis to carry said bolus further into the gastrointestinal tract.   
     
     
       12. In combination with the catheter recited in claim 8: a guidewire;   said guidewire comprising means for emplacing said tube within a patient's gastrointestinal tract.   
     
     
       13. The catheter of claim 12 wherein: said bolus has an inflated diameter which enables the bolus to engage the intestinal wall to assist in the prevention of withdrawal of the tube when the guidewire is removed from the tube.   
     
     
       14. The catheter of claim 8 wherein: said tube has a length such that, when the downstream end of the tube is in the small intestine, the upstream end of the tube extends outwardly through the nose.   
     
     
       15. The catheter of claim 8 wherein: said tube has a length such that, when the downstream end of the tube is in the small intestine, the upstream end of the tube extends outwardly through the patient's skin adjacent the stomach.   
     
     
       16. The catheter of claim 8 and comprising; a radio-opaque stripe in said tube running from the tube's downstream end to the tube's upstream end.   
     
     
       17. The catheter of claim 8 and comprising: a radio-opaque area at the downstream end of the tube.   
     
     
       18. A method of replacing (a) a first catheter having upstream and downstream ends, an inflatable bolus near said downstream end, and a tip opening in said downstream end communicating with a feeding lumen communicating with means for connecting said feeding lumen at said upstream end with a source of nutritive or medicinal material with (b) a second catheter having upstream and downstream ends, and a tip opening in said downstream end communicating with a feeding lumen communicating with means for connecting said feeding lumen at said upstream end with a source of nutritive or medicinal material, said method comprising the steps of: emplacing said first catheter in the gastrointestinal tract;   inserting in said feeding lumen of said first catheter, a guidewire having upstream and downstream ends;   removing said first catheter over said guidewire with said guidewire exiting said first catheter through said tip opening;   inserting the upstream end of said guidewire in said tip opening of said second catheter;   sliding said second catheter over said guidewire while holding said guidewire in place in the patient's gastrointestinal tract;   and removing said guidewire when said downstream end of said second catheter reaches the downstream end of said guidewire.